Engaged, Informed Patients Help Ensure Better Outcomes

LAS VEGAS—Patient engagement is like a “blockbuster drug,” according to Barbara L. Kornblau, JD, OTR/L, CPE, DASPE, Professor of Occupational Therapy at Florida A&M University in Tallahassee, Florida.

“Patient engagement benefits everyone,” said Kornblau to attendees at PAINWeek 2014, who is a chronic pain patient, herself. “Research shows patient engagement improves health outcomes, lowers costs, improves patient care and decreases medical errors.” Participatory medicine allows patients to “shift from being mere passengers to responsible drivers of their health,” with providers encouraging and valuing them as “full partners.”

That's not always easy.

Shared decision-making can require changes in providers' clinical habits and approach from outmoded paternalistic models, and patient/provider power dynamics to foster collaboration and patient engagement. The provider must share decision-making with patients and view the healthcare relationship as a partnership. Knowing about one's medical condition “levels the playing field,” Kornblau said. And that can improve patient outcomes.

“Research shows that engaged patients with chronic conditions are more likely to adhere to treatment regimens,” she notes. “Give your patients a copy of your office visit notes. Research shows that when office visit notes are shared patients become more active in their own care and show better outcomes.”

Communication, careful listening, and education are key: for patients to participate in clinical decision-making, “both the patient and provider must recognize a decision is required. Both must know and understand the best available evidence regarding risks and benefits for each option. Decisions must take into account both the provider's guidance and the patient's values and preferences,” Kornblau said.

The goal of participatory medicine is the “e-patient,” Kornblau explained: a patient that is engaged, equipped, enabled and empowered. Ultimately, it's about lessening pain, increasing patients' understanding or awareness of the causes of their pain, and participation in planning and implementing treatments that will improve a patient's quality of life.

Traditional patient education alone is not enough, she emphasized. “Evidence suggests that mere patient education is ineffective to change patient behavior.” Education is just one part of patient engagement. Patient decision aids can help ease the process, structuring provider/ patient discussions and ensuring that patients learn about their condition and treatment options, and communicate their values.

Option grids are “short tools for comparing health options,” Kornblau explained. “Option grids are brief, easy-to-read tools made to help patients and providers compare alternative treatment options.” Evidence based option grids are available online at www.OptionGrid.org, she noted. The end result? Engaged, empowered patients.

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